mation it provides regarding their risk. While low-risk patients are often relieved by their results, higher-risk patients also find knowing their results empowering and useful to tailor their management. Moreover, the improved overall surviv-al and melanoma-specific survival is a powerful finding that patients appreciate, and clinicians should consider as an evi-dence-based rationale for implementing the 31-GEP test into practice.” —SHANNON TROTTER, DO “Consensus statements are crucial in bridging evidence gaps and promoting the adoption of innovative clinical strate-gies. In light of the limitations present in current staging guidelines for melanoma, the expert panel ’ s recommendations, which are backed by statistically signifi-cant findings, provide essential direction for clinical decision-making, especially in the context of SLNB. These insights enable clinicians to translate complex data into actionable steps, ensuring that each patient receives care that is not only evidence-based but also personalized to their unique clinical profile.” —ANDREW BAKER, MPAS, MBA, PA-C Durgham RA, Nassar SI, Gun R, et al. The prog-nostic value of the 31-gene expression profile test in cutaneous melanoma: A systematic review and meta-analysis. Cancers (Basel). 2024;16(21):3714. https://pubmed.ncbi.nlm.nih.gov/39518150/ This paper reports findings from a systematic review and meta-analysis con-ducted to evaluate the prognostic perfor-mance of the 31-gene expression profile (31-GEP) test in cutaneous melanoma. It included 13 studies representing diverse geographic regions that reported survival outcomes stratified by 31-GEP class for a total of 14,760 patients. The literature searches were performed on July 1, 2024, were done in four databases, and selected only English-language articles. The meta-analysis results showed that the 31-GEP consistently stratified patients into clinically meaningful risk groups; patients with a Class 2B result consistently had worse outcomes than those with a Class 1A result for five-year melanoma-specific survival, three-year overall survival, three-year and five-year recurrence-free survival, and three-and five-year distant metasta-sis-free survival. The researchers conclud-ed that the 31-GEP is a promising tool for enhancing risk stratification and poten-tially improving patient outcomes in the management of cutaneous melanoma. “As a gold standard for comprehensive data evaluation, a meta-analysis allows for a comprehensive way to synthesize data. The authors included 13 studies evaluating the 31-GEP test in over 14,700 patients from different geographic areas. The results show that Class 1A consis-tently demonstrates better outcomes compared to Class 2B across various sur-vival metrics. These findings are largely consistent with another meta-analysis performed by Greenhaw et al. 1 “In their article, Durgham et al. empha-sized the value of risk stratification and future applications for GEP testing to escalate or de-escalate care. However, the authors also allude to the value of clinicopathological features in assessing melanoma risk and how they are lacking with the 31-GEP test. The studies includ-ed in the meta-analysis were performed before the advent of the i31-GEP test that integrates the 31-GEP score with patient-specific clinicopathological char-acteristics. As a result, the i31-GEP test provides an individual risk of recurrence and likelihood of sentinel lymph node positivity and offers personalized results so that treatment can be tailored to the patient. “Even with the strength of evidence of the prognostic value of the 31-GEP test, it does not replace our staging system but rather enhances it. The 31-GEP test is best used alongside AJCC Staging and NCCN Guidelines to better inform treat-ment and surveillance conversations.” —SHANNON TROTTER, DO “ As an experienced Dermatology Physi-cian Assistant engaged in both clinical practice and national leadership, I found this study particularly validating of the “From my collaborative care standpoint, these findings underscore the importance of incorporating genomic testing into routine melanoma management to refine prognostic discussions and guide more tailored surveillance strategies.” —Andrew Baker, MPAS, MBA, PA-C November/December 2025 Supplement | S5
The Dermatology Digest November/December 2025 Castle Supplement: S-5
